Parikh Chandni, Ni Rachel, Gangi Devon, Hill Monique Moore, Iosif Ana-Maria, Maqbool Shy, Wagner Liliana, Ozonoff Sally
Autism Discovery Institute, Rady Children's Hospital, San Diego, CA, USA.
Department of Psychiatry & Behavioral Sciences, MIND Institute, University of California, Davis, Sacramento, CA, USA.
J Autism Dev Disord. 2025 Sep 16. doi: 10.1007/s10803-025-07016-2.
Most telehealth studies have focused on caregiver satisfaction with autism spectrum disorder (ASD) assessments. Few have examined caregiver perceptions of direct-to-home telehealth evaluations for children with developmental concerns broader than ASD. The current study explored caregiver perspectives (N = 439) of the telehealth process, including technology barriers and satisfaction with remote delivery of diagnostic feedback, before and after a 24-month tele-assessment, in children from four outcome groups (ASD, Speech-Language Concerns, Other Developmental Concerns, and No Concerns). The results indicated overall high levels of caregiver satisfaction and acceptability across all outcome groups, although the ASD group had a lower rate (89%) than the other groups (99-100%) of rating "very true" to feeling like a valued partner in the tele-assessment, the evaluation meeting their needs (89% v. 94-99%), and understanding the results (86% v. 96-98%). Families of children with Speech-Language Concerns, the largest diagnostic outcome group, were highly satisfied and found tele-assessment acceptable. There were no differences in caregiver perceptions of the tele-assessment process based on whether they had prior concerns about their child or not. Few technology barriers were reported by any groups and socio-demographic variables (race, ethnicity, socioeconomic status, travel distance from medical center) were not associated with differences in technology access or satisfaction with the tele-evaluations. Overall, these findings support the use of tele-assessment for a wide range of children whose families may not have access to in-person assessment services, as well as suggest ways to further improve remote models of care.
大多数远程医疗研究都聚焦于照顾者对自闭症谱系障碍（ASD）评估的满意度。很少有研究考察照顾者对针对发育问题比ASD更广泛的儿童的直接到家的远程医疗评估的看法。本研究探讨了四个结果组（ASD、语言问题、其他发育问题和无问题）的儿童在进行24个月的远程评估前后，照顾者（N = 439）对远程医疗过程的看法，包括技术障碍以及对远程提供诊断反馈的满意度。结果表明，所有结果组的照顾者总体满意度和接受度都很高，尽管ASD组在认为自己是远程评估中有价值的合作伙伴（89%，低于其他组的99 - 100%）、评估满足他们的需求（89%对94 - 99%）以及理解评估结果（86%对96 - 98%）方面的评分低于其他组。语言问题儿童组是最大的诊断结果组，其家庭对远程评估高度满意并认为可以接受。照顾者对远程评估过程的看法，无论他们之前是否担心自己的孩子，都没有差异。任何组报告的技术障碍都很少，社会人口统计学变量（种族、族裔、社会经济地位、与医疗中心的距离）与技术获取或对远程评估的满意度差异无关。总体而言，这些发现支持对广泛的儿童使用远程评估，这些儿童的家庭可能无法获得面对面的评估服务，同时也提出了进一步改进远程护理模式的方法。
